目的 研究清开灵颗粒联合注射用美罗培南治疗肺部感染的临床疗效。方法 选取2016年5月-2018年5月云南省传染病专科医院收治的60例肺部感染患者为研究对象，将所有患者随机分为对照组和治疗组，每组各30例。对照组患者静脉注射注射用美罗培南，500 mg加入到0.9%氯化钠溶液250 mL中，1次/8 h；治疗组在对照组治疗的基础上口服清开灵颗粒，1袋/次，3次/d。两周患者持续治疗14 d。观察两组的临床疗效，比较两组的临床症状缓解时间、血清学指标、血清炎性因子水平。结果 治疗后，对照组和治疗组的总有效率分别为80.00%、90.00%，两组比较差异有统计学意义（P<0.05）。治疗后，治疗组患者咳痰消失时间、体温恢复时间、肺部X片恢复正常时间显著短于对照组，两组比较差异有统计学意义（P<0.05）。治疗后，两组患者一氧化氮（NO）和血管紧张素转换酶（ACE）水平均显著降低，胆碱酯酶（ChE）水平显著升高，同组治疗前后比较差异有统计学意义（P<0.05）；且治疗组患者NO、ACE和ChE水平明显优于对照组，两组比较差异有统计学意义（P<0.05）。治疗后，两组患者C反应蛋白（CRP）和降钙素（PCT）水平均显著降低，同组治疗前后比较差异有统计学意义（P<0.05）；且患者治疗组CRP和PCT水平明显低于对照组，两组总有效率比较差异具有统计学意义（P<0.05）。结论 清开灵颗粒联合注射用美罗培南治疗肺部感染具有较好的治疗效果，能改善临床症状，降低血清炎性因子水平，具有一定的临床推广应用价值。

Objective To study the efficacy of Qingkailing Granules combined with Meropenem for injection in treatment of pulmonary infection. Methods Patients (60 cases) with pulmonary infection in Yunnan Provincial Infectious Diseases Hospital from May 2016 to May 2018 were randomly divided into control and treatment groups, and each group had 30 cases. Patients in the control group were iv administered with Meropenem for injection, 500 mg added into normal saline 250 mL, once every 8 h. Patients in the treatment group were po administered with Qingkailing Granules on the basis of the control group, 1 bag/time, three times daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacies were evaluated, and clinical symptoms remission time, serological indicators, and serum levels of inflammatory factors in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 80.00% and 90.00%, respectively, and there was difference between two groups (P<0.05). After treatment, expectoration disappear time, body temperature recovery time, and pulmonary X-ray returned to normal time in the treatment group were significantly shorter than those in the control groups, and there was difference between two groups (P<0.05). After treatment, the levels of NO and ACE in two groups were significantly decreased, but the levels of ChE in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And the serological indicators, in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). After treatment, the levels of CRP and PCT in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the serum levels of inflammatory factors in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). Conclusion Qingkailing Granules combined with Meropenem for injection has clinical curative effect in treatment of pulmonary infection, can improve clinical symptoms, and reduce the serum level of inflammatory factors, which has a certain clinical application value.

R974